Yoga is a widespread practice in India, combining breathing, meditation, and strengthening movement. Recent studies suggest Yoga has beneficial effects on stress levels, depression, and pain from arthritis. However, we also know that while Yoga improves strength and flexibility, it can cause injury. A common injury in Yoga is pain arising from the buttock, also known as Yoga butt or hip injury.

What is a Yoga butt injury? 

In medical circles, a yoga butt injury is known as proximal hamstring tendonitis or high hamstring tendinopathy. Tendonitis is related to overload and swelling of the tendon, causing pain with movement or stretching. Additionally, pain can be due to tightness in the piriformis muscle in the buttock, also known as piriformis syndrome.

Usually, Yoga participants report pain in the buttock crease aggravated by poses that stretch the hamstring, such as the compass stretch, forward fold, or downward dog with the knees extended. Occasionally, the pain can travel to the mid to lower thigh but rarely below the knee.

Common causes of yoga butt or hip injury 

foward fold pose

 

One of the most common causes of overload of the hamstring tendon is relying on the hamstring muscles rather than other muscles during certain poses. For example, forward fold poses that rely on bending at the hips without equal movement of the spine will lead to the overload of the hamstring tendon. Also, repetitive hip movements that occur in certain types of Yoga, such as Vinyasa and Bikram Yoga, can increase the risk of hamstring tendonitis. Finally, inadequate strengthening of the hamstring and glutes rather than just stretching will increase susceptibility to this condition.

How to treat a Yoga butt or hip injury 

Firstly, you need to see an experienced sports doctor to confirm a diagnosis and rule out other causes of buttock pain. Further imaging is often required, such as an MRI scan to confirm tendon swelling.

Once the diagnosis is confirmed, treatment is focused on modifying Yoga practice and strengthening the hamstring and other pelvic muscles.

Modification of Yoga poses

modified downward dog yoga

The best thing to do is to rest from intense Yoga. Generally, we suggest rest from more intensive power Yoga and limiting your practice to restorative Yoga. On return to Yoga, it is essential to avoid poses that place high tension on the tendon, such as forward pose, lotus pose, and compass stretch. In addition, modification of Yoga poses is essential to reduce stretch on the hamstring tendon. For example, performing the downward-facing dog with slightly bent knees rather than fully extended. Also, send your hips to the sky rather than lowering your feet to the ground. Another example is the standing forward pose performed without full hip flexion and slightly bent knees.

Hamstring tendonitis exercises  

In addition to modification of Yoga intensity and poses, we suggest exercises to strengthen the hamstring and buttocks. Some examples include hamstring bridges (double leg to single leg), walking lunges with weight, holding lotus pose, and lying hamstring bridge. Gluteal exercises include single-leg squats and walking side clams with a band. This blog by Scott Newton explains the principles of strengthening for hamstring origin tendonitis.

Adjunct treatment for Yoga Butt injury

In cases that prove challenging, ice and a week’s course of anti-inflammatories such as oral ibuprofen will help. For chronic issues, we suggest either shockwave therapy or tendon injections. As injections are invasive, you need to try more non-invasive interventions first. Dr. Masci explains how to treat hamstring tendonitis and options to treat complex cases. 

Final word from Sportdoctorlondon 

The positives of Yoga outweigh the negatives. However, you must be careful when progressing both the frequency and intensity of your classes. If you develop a Yoga butt injury, you should see an expert in Sports Medicine who understands Yoga principles and will offer you options to get you better.

seated pose yoga

Dr Masci is a specialist sports doctor in London. 

He specialises in muscle, tendon and joint injuries.